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Predictors of Statin Adherence, Switching, and Discontinuation in the USAGE Survey Understanding Statin Use in America and Gaps in Patient Education



Predictors of Statin Adherence, Switching, and Discontinuation in the USAGE Survey Understanding Statin Use in America and Gaps in Patient Education



Journal of Clinical Lipidology 7(3): 245-246



Although statins have been shown to reduce cardiovascular disease mortality less than half of U.S. adults achieve their LDL-C goal. In many patients initiated on a statin, adherence rates decrease over time. To characterize current and former statin users, identify reasons for the discontinuation or switching of statins and identify factors associated with adherence. The USAGE Survey is a cross-sectional, self-administered Internet-based survey of 10,138 U.S. adults fielded September-October 201The following statin users were identified and compared: adherent non-switchers, adherent switchers, nonadherent switchers, and discontinuers. Univariate and multivariate models using a priori covariates for adherence and discontinuation were examined. Most participants were current statin users adherent with their prescribed statin (82.5%, n=8371). Former statin users or discontinuers (12%, n=1220) cited muscle side effects as the primary reason for discontinuation (60%), followed by cost (16%) and then perceived lack of efficacy (13%). Discontinuers were less satisfied with their physicians explanation of cholesterol treatment, more likely to use the internet to research statins and less likely to undergo frequent cholesterol monitoring. Among adherent statin users, the primary reasons for switching was muscle side effects (33%) and cost (32%), Individuals at risk for non-adherence included those with low household income, muscle side effects on statin therapy, and those taking medication for cardiovascular disease. Statin related muscle side effects are common and contribute significantly to rates of discontinuation, switching, and non-adherence. Improved physician patient communication about statin side effects and benefits are necessary to improve both adherence and outcomes.

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Accession: 036804704

Download citation: RISBibTeXText

DOI: 10.1016/j.jacl.2013.03.029


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